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Biomedical subjects

B Jones

Publications and source records attributed to B Jones.

At least 397 records · Page 22Linked to original sources
PubMed1990

Clomipramine in obsessive-compulsive disorder: clinical response and plasma levels.

Two related data sets are presented that point to a specific pharmacological effect and support a predominantly serotonergic mediation of clomipramine's antiobsessional effect. A significant placebo versus clomipramine contrast from both the between- and within-group perspectives was found in 25 patients with moderate to severe obsessive-compulsive disorder of at least 2 years' duration and no evidence of depression who completed a double-blind, placebo-controlled, 10-week study. There was no significant improvement in the placebo group, six of whom subsequently improved with clomipramine. Analysis of the clinical significance of pharmacotherapy and the relationship between outcome and plasma drug concentrations in 33 obsessive-compulsive disorder patients treated with clomipramine (239.4 +/- 57.0 mg/day) revealed that 47% of the patients were rated in the subclinical range with one third of the sample being virtually symptom-free. Plasma levels of clomipramine, but not N-desmethylclomipramine, correlated significantly with posttreatment outcome measures, with responders having significantly higher clomipramine levels and a trend toward lower desmethylclomipramine ratios.

Adult↗
PubMed1990

The relationship of plasma clomipramine and N-desmethylclomipramine to response in obsessive-compulsive disorder.

The clinical significance of the effects of pharmacotherapy and the relationship between plasma tricyclic concentrations and outcome in 33 obsessive-compulsive disorder (OCD) patients who completed 10 weeks of treatment with clomipramine (239.4 +/- 57.0 mg/day) were analyzed. Results revealed that at the end of treatment, OCD symptoms had decreased to a subclinical level in 15 (47%) patients and that nearly 33 percent of the sample was virtually symptom free. However, 1 out of 4 patients failed to improve. Analysis of plasma levels (clomipramine 169.9 +/- 102.1 ng/ml; N-desmethylclomipramine 379.0 +/- 160.6 ng/ml) revealed that responders had significantly higher clomipramine levels and a trend toward lower desmethylclomipramine/clomipramine ratios. A significant degree of correlation was also obtained between plasma levels of clomipramine, but not N-desmethylclomipramine, and post-treatment outcome measures.

Adult↗
PubMed1989

Treatment of Wilms' tumor. Results of the Third National Wilms' Tumor Study.

The Third National Wilms' Tumor Study sought to reduce treatment for low-risk patients and find better chemotherapy for those at high risk for relapse. Eligible patients (1439) were randomized according to stage (I-IV) and histology (favorable [FH] or unfavorable [UH]), and contributed data to survival and relapse-free survival (RFS) analyses. Four-year (postnephrectomy) survival percentages and randomized treatment regimens for low-risk patients were 96.5% for 607 Stage I/FH patients who received dactinomycin (Actinomycin D [AMD], Merck Sharp & Dohme, West Point, PA) and vincristine (VCR) for 10 weeks versus 6 months; 92.2% for 278 Stage II/FH patients; and 86.9% for 275 Stage III/FH patients who received AMD + VCR +/- Adriamycin (ADR, Adria Laboratories, Columbus, OH) for 15 months. Stage II/FH patients also had either zero or 2000 cGy irradiation (RT) postoperatively and Stage III/FH patients either 1000 or 2000 cGy. Four-year survival was 73.0% for 279 high-risk patients (any Stage IV, all UH) who received postoperative radiation therapy (RT) and AMD + VCR + ADR +/- cyclophosphamide (CPM). Statistical analysis of survival and RFS experience shows that the less intensive therapy does not worsen results for low-risk patients and CPM does not benefit those at high risk.

Adolescent↗
PubMed1989

Life satisfaction across treatment methods for patients with end-stage renal failure.

After a report which challenged the generally-held view that renal-transplant recipients have a psychological advantage compared with patients who undergo dialysis, we surveyed the quality of life and psychological distress in all patients who were managed by renal transplantation or dialysis at The Royal Newcastle Hospital Renal Unit. A questionnaire was mailed to patients which covered demographic daily illness severity; the quality of life (satisfaction with life in general, general health, and sexual, family and social relationships); a 28-item general-health questionnaire; a life-event schedule; and a locus-of-control scale. The response rate was 88%. Data were obtained on 138 subjects of whom half (69 subjects) were renal-transplant recipients. The other 69 patients were divided between those who underwent haemodialysis at home (24 patients); those who underwent haemodialysis in a hospital centre (24 patients); and those who underwent continuous ambulatory peritoneal dialysis (21 patients). The study showed that while transplant recipients rated highest in the various aspects of quality of life, that of patients who underwent haemodialysis at home was nearly equivalent. Although patients with continuous ambulatory peritoneal dialysis were ranked third in terms of their quality of life, this clearly exceeded that of the group that underwent haemodialysis in a hospital centre, which generally shared very-similar demographic characteristics. Contrary to general expectations, no clear difference was found across the four treatment modalities in the proportion of patients who were disturbed psychologically or who had a history of treatment for "nervous" problems. The results confirm the superiority of renal transplantation in the treatment of end-stage renal disease but highlights the role of continuous ambulatory peritoneal dialysis as a well-tolerated alternative in the treatment of end-stage renal disease.

Female↗
PubMed1989

Psychogenic dysphagia and globus: reevaluation of 23 patients.

Despite warnings against attributing dysphagia to psychological causes, the diagnoses of "psychogenic dysphagia" or "globus hystericus" have been previously applied to 13% of patients referred to the Johns Hopkins Swallowing Center. This paper reports the results of reevaluation of 23 patients previously diagnosed as having symptoms of psychogenic origin. The Swallowing Center evaluation documented an explanation for symptoms in 15 (65%). No cause of dysphagia could be documented in eight patients. All five patients with the "globus sensation" had a documentable abnormality of swallowing. Overall, nine patients had esophageal pathology, while six had pharyngeal disease. Five had structural lesions constricting the lumen, while 10 had motor dysfunction of either the pharynx or esophagus. Review of the referral records of these patients indicates the quality of prior evaluation for patients previously labeled as having a swallowing disorder of psychogenic origin is variable, and that once attribution of symptoms to psychogenic causes is made, the diagnosis is rarely reconsidered. We conclude that attribution of the diagnosis of psychogenic dysphagia should be made with caution, and only after thorough evaluation. Any change or progression of symptoms should prompt a careful re-evaluation.

Adolescent↗
PubMed1989

How I do it: examination of the patient with dysphagia.

Difficulty in swallowing is not an uncommon symptom. Approximately 10,000 persons choke to death every year in the United States, and at least 50% of patients in nursing homes have some difficulty eating or drinking. Dysphagia will become an increasing problem as the population continues to age, as more intensive resuscitative measures are applied, and as more aggressive head and neck surgery is performed. The practicing radiologist should be familiar with the examination technique and interpretation of swallowing studies.

Deglutition Disorders↗
PubMed1989

Can zeolites decrease the uptake and accelerate the excretion of radio-caesium in ruminants?

The zeolite group of minerals has been suggested as a means of decreasing the uptake of radio-caesium by humans and domestic animals, and also to accelerate the excretion of radio-caesium which has already been absorbed. Artificial mordenite, one of the zeolites being considered for this purpose, was dispersed in liquid paraffin and administered to goats and lambs fed radio-caesium-contaminated hay. Faeces and urine were collected separately and analyzed by gamma spectrometry on each day of the experimental period. At a dose of 10 g day-1 of mordenite, the amount of radio-caesium excreted was more than double the amount ingested with the fodder, due to extraction of the radio-caesium stored in the body. Initially, the effect/dose ratio was even higher. It is shown conclusively that mordenite can reduce the uptake of radio-caesium by goats and lambs, and also, without changing the fodder, reduce their body burden. A similar, preliminary experiment on man was less successful. In another experiment, boiling reindeer meat with mordenite reduced its radio-caesium content to 8%.

Aluminum Silicates↗
PubMed1989

Multiple neuroectodermal tumors arising in a mature cystic teratoma of the ovary.

Benign cystic teratomas are common, comprising 11-20% of all ovarian tumors. Neural elements can be identified in 38% of teratomas, but the development of a malignant neural neoplasm in an ovarian tumor of this type is rare. Multiple neuroectodermal tumor foci have not been previously described in association with a mature cystic teratoma of the ovary.

Adult↗
PubMed1989

Micropenis and congenital adrenal hypoplasia.

Micropenis is often an early sign of congenital hypopituitarism. It has also been associated with congenital adrenal hypoplasia in infants with anencephaly and pituitary agenesis. This report is on two infants with micropenis and congenital adrenal hypoplasia. One presented with a similar clinical course and postmortem findings to previously reported cases of adrenal hypoplasia and pituitary agenesis. The other patient represents the first reported case of an infant with micropenis and congenital adrenal hypoplasia in the absence of pituitary agenesis. The histologic patterns of adrenal hypoplasia, as well as the etiologic and clinical implications of its association with micropenis, are discussed.

Adrenal Glands↗
PubMed1989

Simultaneous administration of rhesus rotavirus vaccine and oral poliovirus vaccine: immunogenicity and reactogenicity.

Rotavirus vaccine could be administered most efficiently if it were incorporated into routine childhood immunizations and did not interfere with the immune response to the other vaccines, principally oral poliovirus vaccine (OPV). We conducted a placebo-controlled randomized trial giving oral rhesus rotavirus vaccine (RRV) (strain MMU 18006) alone and together with a child's first dose of OPV and diphtheria-tetanus toxoids-pertussis to examine the possible interaction of these vaccines. A total of 102 infants 2 to 3 months of age were randomized into 3 groups to receive (1) RRV with OPV, (2) placebo with OPV and (3) RRV 2 weeks after OPV. All infants were given diphtheria-tetanus toxoids-pertussis. Serum samples were collected at the time of OPV immunization and 3 to 5 weeks later. Three to 5 weeks after OPV immunization 60% of infants had a 4-fold rise in neutralization titer to at least one of the three poliovirus serotypes. The rate of antibody response to poliovirus did not differ by RRV groups but a lower rate was correlated with a shorter interval (3 vs. 5 weeks) between OPV vaccination and antibody measurement. Fifty-six percent of infants had a 4-fold rise of IgA and 62% had a 4-fold rise of neutralizing antibody to RRV; this rise did not differ according to time of OPV immunization. RRV was not associated with side effects and may be safely given with OPV to infants 2 to 3 months of age.

Antibodies, Viral↗
PubMed1989

Bulky extramedullary plasmacytomata: rare mode of relapse in myelomatosis.

In two cases of myelomatosis relapse was accompanied by the development of bulky extramedullary plasma cell tumours, which created serious management problems. In both cases the histology was of a poorly differentiated plasmacytoid tumour with frequent mitoses. In one case paraprotein had completely disappeared from the serum and urine after six months' treatment with melphalan alone but did not correlate with improved survival. It is concluded that extramedullary spread of myelomatosis in the form of bulky tumour deposits is a rare and ominous mode of tumour progression or relapse. Rises in serum and urinary paraprotein concentrations are not the inevitable signs of relapse.

Cecal Neoplasms↗